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Alaska rates for HCPCS 15273

Application of skin substitute graft to trunk, arms, legs, total wound surface area greater than or equal to 100 sq cm; first 100 sq cm wound surface area, or 1% of body area of infants and children

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $7,079.46 / $14,125.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$181.97 / $288.40 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $676.08 / $1,000.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $275.42 / $1,479.11
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.87 / $660.69 / $954.99
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $812.83 / $1,288.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.96 / $316.23 / $1,479.11
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.26 / $371.54 / $977.24
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $549.54 / $831.76